Cardiovascular function in women with recurrent miscarriage, pre-eclampsia and/or intrauterine growth restriction

Objective: To investigate prepregnancy cardiovascular function and risk factors in women with previous pregnancy complications. Methods: Thirty-four women with previous normal pregnancy (controls), 26 with unexplained recurrent miscarriage (RM) and 14 with pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR), planning to conceive were recruited. Brachial and central blood pressures (BP), cardiac output (CO), peripheral vascular resistance (PVR), aortic stiffness, blood biochemistry and platelet aggregation were assessed. Results: Women with previous PE/IUGR had higher brachial diastolic BP (78 +/- 9 vs 71 +/- 7 mmHg; p = 0.03), central systolic BP (107 +/- 10 vs 99 +/- 8 mmHg; p = 0.03), mean arterial pressure (92 +/- 10 vs 84 +/- 8 mmHg; p = 0.01) and PVR (1499 +/- 300 vs 1250 +/- 220 dynes.s(-1) cm(-5); p = 0.005), than the controls. No differences were observed in either cardiovascular function or blood biochemistry in women with unexplained RM compared with the controls. Women with previous PE/IUGR though not with RM had a stronger family history of cardiovascular disease (CVD) than controls. Conclusions: Women with previous PE and/or IUGR had higher BP and PVR compared with controls, which may predispose them to CVD later in life. However, in the absence of underlying vascular pathology, women with unexplained RM did not have abnormal cardiovascular function. Prepregnancy period provides an opportunity to identify cardiovascular risks in relation to previous obstetric history.